BACKGROUND: Cosmetic tourism describes the practice of patients traveling, either domestically or internationally, to seek out cosmetic surgery at lower costs. Despite the seemingly lower initial price tag for the surgery, patients can face devastating consequences from limited preoperative evaluation and postoperative follow-up. Patients are often left alone to manage their wounds, drains and possible complications. The purpose of this study was to assess the most common complications experienced by this population and elucidate the additional burden placed on the healthcare system.
METHODS: A total of 57 patients presented to the emergency department at our institution with cosmetic tourism-related complications from 2018 through 2022. Information regarding patient demographics, procedures performed, complications and hospital resource utilization was analyzed. Wilcoxon rank sum test was used to assess differences in continuous variables. Fisher test was used to assess differences in categorical variables.
RESULTS: A total of 57 patients were identified, with 47% of patients undergoing procedures abroad and 53% undergoing procedures domestically. Overall, 95% of patients were female with a mean age of 39 ± 9.2 years. There were no statistically significant differences in sex, race, ethnicity, educational level, or insurance type between patients who underwent surgery domestically versus abroad. All the domestic cosmetic tourism occurred in Florida while 70% of the abroad patients underwent their procedures in the Dominican Republic, with the remainder occurring in Brazil, Colombia, and Mexico. The most common procedure was abdominoplasty, with 70% of patients undergoing one alone or in combination with other procedures. This was followed by liposuction and gluteal fat grafting (51% and 25%, respectively). Wound dehiscence (33%) and seroma formation (32%) were the most common complications, followed by infection (26%). Regarding healthcare utilization, 23 (40.4%) patients were admitted, 48 (84.2%) underwent at least one imaging study, 29 (50.9%) underwent a bedside or radiology-guided procedure, and 6 (10.5%) required a reoperation.
CONCLUSION: Complications following cosmetic tourism were found to cause significant impacts on both patients and the healthcare system necessitating utilization of radiologic imaging, bedside and operating room procedures, and inpatient management. Our analysis revealed that dehiscence, seroma formation and infection are particularly common complications experienced by this cohort. Greater awareness and patient education about the risks of cosmetic tourism should be implemented to limit the cost burden on patients and hospital systems.